Sandra
Lindstrom seeks judicial review, pursuant to 42 U.S.C. §
405(g), of the decision of the Acting Commissioner of the
Social Security Administration, denying her application for
disability insurance benefits under Title II of the Social
Security Act, 42 U.S.C. § 423. Lindstrom contends that
the Administrative Law Judge (“ALJ”) erred in
finding that she did not have a medically determinable severe
impairment due to multiple chemical sensitivity
(“MCS”) before her date last insured. The Acting
Commissioner moves to affirm.

Standard
of Review

In
reviewing the final decision of the Acting Commissioner in a
social security case, the court “is limited to
determining whether the ALJ deployed the proper legal
standards and found facts upon the proper quantum of
evidence.” Nguyen v. Chater,172 F.3d 31, 35
(1st Cir. 1999); accord Seavey v. Barnhart, 276 F.3d
1, 9 (1st Cir. 2001). The court defers to the ALJ’s
factual findings as long as they are supported by substantial
evidence. § 405(g); see also Fischer v. Colvin,831 F.3d 31, 34 (1st Cir. 2016). “Substantial evidence
is more than a mere scintilla. It means such relevant
evidence as a reasonable mind might accept as adequate to
support a conclusion.” Castillo Condo. Ass’n
v. U.S. Dep’t of Housing & Urban Dev., 821
F.3d 92, 97 (1st Cir. 2016) (internal quotation marks
omitted). “[S]ubstantial evidence does not mean either
uncontradicted evidence or overwhelming evidence” but
instead can be satisfied “even if the record arguably
could justify a different conclusion.” Id.
(internal quotation marks omitted).

Background

Lindstrom
applied for social security disability benefits in 2009,
alleging that her disability began on October 15,
1990.[1]After her application was denied, a hearing
was held before an ALJ in December. The ALJ issued a decision
denying Lindstrom’s claim on February 4, 2011.
Lindstrom appealed the unfavorable decision, and the United
States District Court in the District of Vermont reversed and
remanded for further proceedings.[2]

On
direction from the Appeals Council, a new hearing was held on
October 14, 2015, before the same ALJ who held the first
hearing. The ALJ issued an unfavorable decision on December
22, 2015, and Lindstrom sought judicial review of that
decision.

Lindstrom
was thirty years old in 1990. She has a college degree and
has worked as a sales clerk, waitress, file clerk,
recreational aid, maintenance worker, supervisor of a group
home, and park foreman. She stopped working in 1990 when she
was pregnant because she was having minor reactions to
chemicals in the environment, and she was concerned about the
impact of her reactions on her unborn child. After her son
was born, she stayed at home to care for him.
Lindstrom’s last insured date was December 31, 1995.

Lindstrom
was evaluated in April and June of 1982 because of allergic
reactions. She provided a detailed history of her reactions
to materials and environments beginning in 1979. She
remembered having severe skin reactions in 1979 and 1982 but
follow-up pulmonary testing was normal and a dermatologist
found no reason to pursue patch tests.

Dr.
John Balmes concluded that Lindstrom had developed severe
allergic reactions in the past, that she did not have asthma,
that she had sensitivity to substances in new clothes, and
that her reactions could be due to those substances and
anxiety. Lindstrom’s obstetric record in 1991 notes
that she was severely allergic to chemicals.

Michael
Schaffer, Lindstrom’s chiropractor, wrote a letter in
2009 that he had first treated Lindstrom in 1993. Schaffer
noted that Lindstrom was intensely sensitive to chemicals,
including fumes from his office copy machine, new carpet, and
perfumes worn by others in his office. Lindstrom’s
employer from 1982 to 1990 also wrote a letter that said
Lindstrom struggled with chemical allergies, which caused her
to miss work and eventually to stop working.

Medical
notes in 1998 mentioned Lindstrom’s chemical
sensitivities. Notes from the Shepard of Hope Clinic in 2002
stated that Lindstrom had an extreme allergy to new carpet
but do not indicate any treatment being provided for her
allergy. Treatment notes in 2006 mentioned her many chemical
sensitivities but do not indicate treatment. Lindstrom was
tested for allergies in August of 2008, which showed strong
reactivity to polysorbate 60, fluride, indocine, penicillin,
and sulfamethosozole, along with moderate and mild reactions
to certain other substances.[3]

In
September of 2009, Nurse Practitioner April Brumson, from the
Soujourns Community Health Clinic, noted that Lindstrom had
headaches because of multiple chemical sensitivities and that
her sensitivities also caused anaphylaxis, compromised
immunity, poor concentration, and an inability to process
information. Brumsom thought the cognitive changes were more
disabling than headaches, that avoiding triggers was the best
treatment, and that her reactions were worsening over time.
Brumsom’s opinion was reviewed and approved by Dr. Gary
Clay.

Dr. N.
Thomas LaCava of Francis Hollistic Medical Center wrote in
October of 2009 that Lindstrom had chemical sensitivities,
chronic fatigue, food allergies, thyroiditis with
hypothyroidism, and a history of anaphylaxis. Her treatment
involved avoiding chemicals that triggered a reaction, and
her prognosis was chronic, permanent, and unremittent. For
that reason, Dr. LaCava thought Lindstrom would always be
absent from work.

Lindstrom
also obtained an opinion letter in October of 2009 from Dr.
Linda Haltinner who worked at the Soujourns Clinic. Dr.
Haltinner wrote that Lindstrom was being treated for symptoms
of MCS, that her reactivity was extreme and interfered with
her normal life activities. She recounted an incident at the
clinic when Lindstrom had a reaction and had to be escorted
outside to allow her thinking to clear.

Nurse
Practitioner Brumson provided another opinion in July of 2010
in which she wrote that Lindstrom’s disability was due
to environmental allergies and multiple chemical
sensitivities as well as asthma caused by chemical exposure.
An ideal controlled environment could best be approached in
Lindstrom’s home. Dr. Brumson stated that
Lindstrom’s limitations had existed since 1979 based on
Lindstrom’s reports.

Dr.
Alex Bingham provided an opinion in December of 2010 that
Lindstrom had been totally disabled since 1999 and had been
partially disabled from 1990 to 1999. He found that Lindstrom
was disabled due to MCS. He recounted Lindstrom’s
symptoms and her history of reactions. He thought that she
could not spend time in an environment with exposure to a
wide array of chemicals and could function only in a highly
controlled environment at home.

At the
first hearing on December 15, 2010, Lindstrom testified to a
history of physical responses to environmental conditions,
including cigarette smoke and pesticides, and to being
chronically sick. She testified that when she became pregnant
she stopped working because she was afraid of the effect of
her reactions on the baby. After her son was born in 1991,
her sensitivity to environmental conditions became worse and
Lindstrom stayed at home to care for him.

She
testified that her reactions to chemicals in the environment
included migraine headaches and anaphylactic shock. She said
that she had anaphylactic reactions in 1993, 2004, and 2005
but was able to treat the episodes with Benadryl except for
the bee sting in 2004 when she used an Epipen. Lindstrom
...

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